Building a Bridge from Fragmentation to Accountability — The Prometheus Payment Model

In the current debate over health care reform, many observers are proposing new delivery structures to move U.S. health care away from fragmentation, poor performance, and dysfunction toward accountability for high-value care. Ideally, these new structures would promote clear accountability for both improving quality and controlling costs and would encourage health care professionals to organize themselves into teams working on behalf of patients. For such structures to be sustainable, however, the payment system must reward professionals for the quality and efficiency of services, rather than the quantity.Our fee-for-service payment schemes have contributed to, if not largely created, the current . . .